The Neurobiology of Ecstasy (MDMA)

5: Short-term (acute) effects of ecstasy

Explain that when a person uses ecstasy, the increase in serotonin in different brain regions (i.e., the areas where serotonin neurons traveling from the raphe nucleus terminate) causes psychological effects. These include elevated mood and feelings of empathy. The ecstasy is also reinforcing, which means that its pleasurable properties increase the likelihood that the person will take it again. Tell the students that drugs that are reinforcing are usually addictive.

Students might ask you if ecstasy is addictive. Scientists and health professionals don't have a definitive answer yet. For now there are several pieces of evidence that suggest that ecstasy has the potential to be addictive. In one study of ecstasy users, 43% of respondents met criteria that are commonly used to determine dependence for other drugs of abuse. This included symptoms such as continuing to use the drug despite knowledge of physical or psychological harm, experiencing withdrawal effects, and tolerance (or diminished response) to repeated use of ecstasy. In a research setting, monkeys will administer ecstasy to themselves (they actually press a lever to obtain an injection), just as they do for other addictive drugs. Monkeys will not self-administer drugs that are not addictive. In addition, there is emerging research to show that ecstasy has actions in a specific pathway within the limbic system called the "reward pathway", which can explain it's reinforcing effects. In fact, all addictive drugs act in some way within the "reward pathway". For more information on this, see the NIDA Teaching Packet referenced at the end.

Many of the psychological effects of ecstasy are due to its actions within the limbic system (the amygdala, in red, and hippocampus, in blue, especially). The ability of ecstasy to produce mild stimulation is due to its actions in another part of the limbic system -- the basal ganglia (in purple). It is here where ecstasy's effects on the dopamine system may be important. The heightened perceptions involve the actions of ecstasy in the neocotex (in yellow). ecstasy can also reduce the appetite, because it acts in the hypothalamus (in green), which controls feeding behavior.